Supraglottic Combined Frequency Jet Ventilation Versus Subglottic Monofrequent Jet Ventilation in Patients Undergoing Microlaryngeal Surgery

Bacher, Andreas; Pichler, Katharina M.; Aloy, A.

doi:10.1097/00000539-200002000-00041

Cited by 18 publications

(5 citation statements)

References 13 publications

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“…[23] Various anesthetic agents and a number of alternative anesthetic techniques have been tried with varying results. [4–6] The use of intravenous anesthesia with propofol during microlaryngeal surgery is in widespread clinical practice due to its rapidity and quality of awakening. [7–9]…”

Section: Introductionmentioning

confidence: 99%

Effect of sevoflurane versus propofol-based anesthesia on the hemodynamic response and recovery characteristics in patients undergoing microlaryngeal surgery

2012

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Background:This randomized study was conducted to compare the hemodynamic changes and emergence characteristics of sevoflurane versus propofol anesthesia for microlaryngeal surgery.Methods:Forty adult patients undergoing microlaryngoscopy were randomly allocated into two groups. In propofol group, anesthesia was induced with 2-3 mg/kg propofol and maintained with propofol infusion 50-200 μg/kg/h. In sevoflurane group induction was carried out with 5-8% sevoflurane and maintained with sevoflurane in nitrous oxide and oxygen. The propofol and sevoflurane concentrations were adjusted to maintain the bispectral index of 40-60. All patients received fentanyl 2 μg/kg before induction and succinylcholine 2 mg/kg to facilitate tracheal intubation. The hemodynamic changes during induction and suspension laryngoscopy were compared. In addition, the emergence time, time to extubation, and recovery were assessed.Results:The changes in heart rate were comparable. The mean arterial pressure was significantly lower after induction and higher at insertion of operating laryngoscope in propofol group as compared to sevoflurane group. More patients in propofol group had episodes of hypotension and hypertension than sevoflurane group. The emergence time, extubation times, and recovery time were similar in both groups.Conclusion:We found that sevoflurane showed advantage over propofol in respect of intraoperative cardiovascular stability without increasing recovery time.

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Section: Introductionmentioning

confidence: 99%

Effect of sevoflurane versus propofol-based anesthesia on the hemodynamic response and recovery characteristics in patients undergoing microlaryngeal surgery

2012

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“… 9 In contrast, tracheal intubation avoids most ventilatory problems at the cost of discomfort for the operator, even if a small-diameter intubation probe is used. High frequency jet ventilation can be used with i) a laryngoscope with a specific channel for jet ventilation (i.e., supraglottic jet ventilation), 10 ii) a tracheal catheter placed through the mouth (i.e., subglottic jet ventilation), 11 or iii) a tracheal catheter placed percutaneously through the cricothyroid membrane. 12 However, high frequency jet ventilation remains a marginal technique owing to the requirement for a specific ventilator and the risk of a specific complication, notably pneumothorax.…”

Section: Discussionmentioning

confidence: 99%

High-flow nasal oxygen for suspension laryngoscopy: a multicenter open-label study

et al. 2022

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In this study, we aimed to assess the efficacy of high-flow nasal oxygen (HFNO) to maintain blood peripheral oxygen saturation (SpO2) in patients undergoing suspension laryngoscopy under general anesthesia. Adult patients were included in this bicenter study. After face-mask oxygenation, HFNO at a flow rate of 70 L min−1 and fraction of inspired oxygen 100% was initiated at loss of consciousness. At the end of HFNO, blood gas analysis was performed. Of the 29 included patients, five (17.2%; 95% confidence interval [CI]: 7.6–34.5) presented SpO2 <95% during the first 15 minutes of the procedure and eight patients (27.6%; 95% CI: 14.7–45.7) presented SpO2 <95% throughout the procedure. Six patients (20.7%; 95% CI: 9.8–38.4) required rescue jet ventilation. Median apnea time before SpO2 <95% was 13.5 (interquartile range [IQR]: 10–17.7) minutes. Arterial carbon dioxide tension at the end of the procedure or at the time of study discontinuation was 9.73 (IQR: 8.8–10.9) kPa and was higher than 8 kPa in 88.9% (95% CI: 71.9–96.1) of patients. HFNO was associated with a relatively high incidence of suboptimal oxygen saturation and hypercapnia during suspension laryngoscopy under general anesthesia and may not be considered the reference technique.

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“…Even in the presence of serious airway obstruction, SHFJV has been shown to maintain adequate PO 2 and carbon dioxide (CO 2 ) removal [10, 11]. The goal of including LFJV is to increase minute ventilation and improved CO 2 removal [12] by improving lung recruitment leading to better oxygenation [13]. Sütterlin et al, using a porcine model without respiratory disease, compared SHFJV and single-frequency HFJV in the absence of airway obstruction and concluded that both techniques offer adequate ventilation, except for single-frequency HFJV frequencies ≥ 300 min −1 [14].…”

Section: Superimposed Jet Ventilationmentioning

confidence: 99%

Jet Ventilation during Rigid Bronchoscopy in Adults: A Focused Review

Putz

Mayné

Dincq

2016

BioMed Research International

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The indications for rigid bronchoscopy for interventional pulmonology have increased and include stent placements and transbronchial cryobiopsy procedures. The shared airway between anesthesiologist and pulmonologist and the open airway system, requiring specific ventilation techniques such as jet ventilation, need a good understanding of the procedure to reduce potentially harmful complications. Appropriate adjustment of the ventilator settings including pause pressure and peak inspiratory pressure reduces the risk of barotrauma. High frequency jet ventilation allows adequate oxygenation and carbon dioxide removal even in cases of tracheal stenosis up to frequencies of around 150 min−1; however, in an in vivo animal model, high frequency jet ventilation along with normal frequency jet ventilation (superimposed high frequency jet ventilation) has been shown to improve oxygenation by increasing lung volume and carbon dioxide removal by increasing tidal volume across a large spectrum of frequencies without increasing barotrauma. General anesthesia with a continuous, intravenous, short-acting agent is safe and effective during rigid bronchoscopy procedures.

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Supraglottic Combined Frequency Jet Ventilation Versus Subglottic Monofrequent Jet Ventilation in Patients Undergoing Microlaryngeal Surgery

Cited by 18 publications

References 13 publications

Effect of sevoflurane versus propofol-based anesthesia on the hemodynamic response and recovery characteristics in patients undergoing microlaryngeal surgery

Effect of sevoflurane versus propofol-based anesthesia on the hemodynamic response and recovery characteristics in patients undergoing microlaryngeal surgery

High-flow nasal oxygen for suspension laryngoscopy: a multicenter open-label study

Jet Ventilation during Rigid Bronchoscopy in Adults: A Focused Review

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